Implementing the patient care collaborative model in three general internal medicine units: a mixed-methods healthcare improvement initiative

Autor: Lawrence Mbuagbaw, Elizabeth Barrett, Kelly LoPresti, Julianne Camera, Caroline Gosse, Donna Johnson, Gaya Amirthavasar, John Nashid, Mirabel Mbuagbaw, Thuvaraha Vanniyasingam
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BMJ Open Quality, Vol 9, Iss 2 (2020)
Druh dokumentu: article
ISSN: 2399-6641
82116601
DOI: 10.1136/bmjoq-2019-000815
Popis: Background As part of the scale-up of the Patient Care Collaborative (PCC) at our institution, we explored staff perceptions and patient outcomes at different levels of model implementation in three general internal medicine units.Methods We conducted a mixed-methods embedded experimental healthcare improvement initiative. In the qualitative strand, we conducted five focus group discussions. In the quantitative strand, we used hospital administrative data to compare outcomes (falls per 1000, median length of stay in days and resource use measured as resource intensity weights (RIW), before and after the implementation of the PCC, using χ2 tests, Wilcoxon’s rank sum tests and interrupted time series analyses.Results Staff showed considerable knowledge and acceptance of the PCC but expressed mixed feelings with regards to patient safety, workload, communication and teamwork. Staff perceptions varied by level of implementation of the PCC. A number of falls (overall) in the full implementation phase were not significantly different from the preimplementation phase (227 per 1000 vs 200 per 1000; p=0.449), but the number of moderate to severe falls dropped (12 vs 2 per 1000); p
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